Carcinoma of the pancreas is the fifth most lethal cancer in humans. One major problem in the management of patients with pancreatic neoplasia is the difficulty in establishing a diagnosis early in the course of the disease. The primary objective of this proposal is to further evaluate the potential usefulness of a microplate Leukocyte Adherence Inhibition (LAI) Assay as an immunodiagnostic test for pancreatic cancer. Parameters to be evaluated by the LAI assay include specific antitumor immunity and serum arming and blocking factors. These parameters will be evaluated on "coded" specimens from individuals suspected of having pancreatic cancer on clinical grounds. The relative merit of the LAI assay will be established by a direct comparison to current clinical diagnostic techniques. Serial measurements of these parameters will also be made in patients with pancreatic cancer throughout the history of this disease as it unfolds and is modified by therapy. Each of these parameters will be correlated with extent of disease, recurrence and survival to determine if these parameters alone or in a profile can identify a group of high risk patients for whom additional therapy may be indicated, to identify progression of pancreatic disease earlier and to detect changes resulting from therapy. The secondary objectives of this proposal are to further improve the diagnostic potential of the microplate LAI assay by performing basic studies on the mechanism of reactivity as well as by characterizing by the LAI assay extracts of pancreatic cell lines and biological fluids of pancreatic cancer patients that can serve as a potential standardized source of tumor antigen(s). Gains in any of these areas will result in earlier detection, better therapy and ultimately improved survival for pancreatic cancer patients.